Cinta Mancheño-Velasco, Marta Narváez-Camargo, Daniel Dacosta-Sánchez, Manuel Sánchez-García, Óscar M Lozano
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In general, coordinated care yielded favorable outcomes (higher attendance and lower dropout rates but no differences in retention). The logistic regression analysis identified predictors of patient profiles in coordinated care, emphasizing having a severe mental health disorder (OR = 3.878, 95% CI [3.443, 4.368]; <i>p</i> = .000), being referred by social/health services, or having retired status. Main differences were observed according to the comorbid diagnosis presented, particularly in cases in which the patient had impulse control, hyperkinetic, or cluster C personality disorder.</p><p><strong>Conclusions: </strong>While therapeutic outcomes are influenced by associated comorbidities, the disorders prognosis can be favorable with appropriate treatment. 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引用次数: 0
摘要
目的:这项工作旨在研究双重病理患者的概况和治疗效果,具体取决于患者是在戒毒中心接受治疗,还是在精神健康服务机构的协调模式下接受治疗。研究方法使用了 7225 名双重诊断患者的数据,其中 2417 人(33.5%)接受了精神健康协调模式的治疗。临床信息来自患者的电子健康记录。结果显示根据治疗方式的不同,患者的社会人口学和合并症概况也有所不同。总体而言,协调护理产生了良好的效果(出勤率更高,辍学率更低,但保留率没有差异)。逻辑回归分析确定了协调护理中患者概况的预测因素,强调了患有严重精神疾病(OR = 3.878,95% CI [3.443,4.368];p = .000)、由社会/卫生服务机构转介或退休身份。根据合并诊断的不同,观察到了主要的差异,尤其是在患者患有冲动控制障碍、多动障碍或 C 群人格障碍的情况下。结论:虽然治疗效果会受到相关合并症的影响,但如果治疗得当,失调症的预后还是不错的。此外,通过分析治疗方式的差异,可以预测接受特定服务的患者类型,从而制定有针对性的治疗方案。
Examining Profiles and Treatment Outcomes in Dual Diagnosis: Comparison of Coordinated Treatment With Mental Health Services Versus Addiction Center Alone. A Real-World Data Analysis.
Objective: The aim of this work was to examine the profile and treatment outcomes of patients with dual pathology depending on whether the patients were attending addiction centers or are being treated in a coordinated model by mental health services.
Methods: Data from 7225 dual diagnosis patients were used, of whom 2417 (33.5%) received treatment in the mental health coordinated modality. Clinical information was taken from the patients' electronic health record.
Results: Differences were found in patients' sociodemographic and comorbidity profiles according to treatment modality. In general, coordinated care yielded favorable outcomes (higher attendance and lower dropout rates but no differences in retention). The logistic regression analysis identified predictors of patient profiles in coordinated care, emphasizing having a severe mental health disorder (OR = 3.878, 95% CI [3.443, 4.368]; p = .000), being referred by social/health services, or having retired status. Main differences were observed according to the comorbid diagnosis presented, particularly in cases in which the patient had impulse control, hyperkinetic, or cluster C personality disorder.
Conclusions: While therapeutic outcomes are influenced by associated comorbidities, the disorders prognosis can be favorable with appropriate treatment. Furthermore, analysis of differences according to treatment modality allows for predicting the type of patient who will receive a particular service, which enables the development of tailored treatments.
期刊介绍:
Journal of Dual Diagnosis is a quarterly, international publication that focuses on the full spectrum of complexities regarding dual diagnosis. The co-occurrence of mental health and substance use disorders, or “dual diagnosis,” is one of the quintessential issues in behavioral health. Why do such high rates of co-occurrence exist? What does it tell us about risk profiles? How do these linked disorders affect people, their families, and the communities in which they live? What are the natural paths to recovery? What specific treatments are most helpful and how can new ones be developed? How can we enhance the implementation of evidence-based practices at clinical, administrative, and policy levels? How can we help clients to learn active recovery skills and adopt needed supports, clinicians to master new interventions, programs to implement effective services, and communities to foster healthy adjustment? The Journal addresses each of these perplexing challenges.